Critiquing representations of intellectual disability in occupation-based literature

BACKGROUND

Within and beyond occupation-based scholarship, concerns abound regarding the pervasiveness of discourses that promote a negative, deficit-based view of intellectual disability and associated consequences for disabled people's lives. Such representations risk reducing the complexities of human doing and being and can limit the occupational possibilities of this group. Yet, there is a lack of critically reflexive research exploring how disability is discursively constructed in occupation-based literature.

AIMS/OBJECTIVES

This paper critically analyses representations of intellectual disability within occupation-based literature. It considers the influence of such representations on the occupational possibilities of people labelled intellectually disabled.

METHODS

This review employed a critical interpretive synthesis of 21 peer-reviewed articles from occupational therapy and occupational science that focused on intellectual disability.

RESULTS

Three analytic threads were identified as contributing to how intellectual disability was represented across the reviewed literature: habilitating expected doings, becoming productive citizens, and activated, but insufficient.

CONCLUSION & SIGNIFICANCE

Occupation-based discourses have powerful influence within society, particularly within occupational therapy, regarding understandings of intellectual disability and how these shape occupational possibilities for persons labelled intellectually disabled. Drawing attention to taken-for-granted representations of intellectual disability is essential to promote transformative occupational therapy practice and enhance occupational possibilities for this population.

‘Never think doing a job is easy’: The lived experience of work for people who have an intellectual and developmental disability

Introduction

The proportion of people with an intellectual or developmental disability (IDD) in paid employment is low internationally despite policy efforts. Evidence suggests multiple and varied explanations for this, including organisational, social and personal barriers. That evidence has not focused on first-person experiences which may provide a depth of understanding and explanation of the work-related experiences of people with IDD.

Method

A hermeneutic phenomenological approach and an exploratory research method of a ‘creative collaborative partnership’ was adopted to illuminate the work-related experiences of six people with a mild IDD.

Findings

Six work stories composed of narratives and visual images were collaboratively created revealing a complex range of positive and negative experiences and perspectives of paid work. Five collective narrative frames emerged: the quest ‘to do’, navigating bureaucratic seas, finding a good fit, forging of identity and finding both friend and foe.

Conclusion

The collaborators’ stories highlighted that individuals supporting people with IDD towards or in work, including occupational therapists, need to adopt a nuanced systemic perspective of the context surrounding the person. This includes identifying allies and allowing people with IDD to decide how (if at all) they describe their IDD status to others as they establish their worker identity.

Evidence to Inform Occupational Therapy Intervention With Adults With Intellectual Disability: A Scoping Review

IMPORTANCE

Occupational therapy practitioners use a range of habilitative and compensatory approaches to teach new skills or modify tasks and environments to address occupational performance among adults with intellectual disability (ID); therefore, they must identify and use available evidence to guide intervention planning.

OBJECTIVE

To summarize the scope of evidence that can inform occupational therapy intervention with adults with primary or comorbid ID.

DATA SOURCES

Articles published in peer-reviewed journals between January 2002 and January 2018 and indexed in PubMed, CINAHL, PsycINFO, and Scopus. Study Selection and Data Collection: A total of 159 articles met inclusion criteria and contained information on occupational therapy intervention with adults ages 18 yr or older with primary or coexisting ID.

FINDINGS

Fifty-seven of the 159 articles focused on intervention to address occupational performance outcomes (i.e., employment, self-care, leisure and social interaction, community participation).

CONCLUSIONS AND RELEVANCE

A wide range of literature is available to support occupational therapy intervention with adults with ID. Occupational therapy practitioners may be less knowledgeable about this evidence because much of it is located in non-occupational therapy or international journals. What This Article Adds: This scoping review provides occupational therapy practitioners with evidence to support high-quality occupational therapy intervention with adults with ID.

How Qualitative Case Study Methodology Informs Occupational Therapy Practice: A Scoping Review

Qualitative case study methodology (QCSM) is a useful research approach that has grown in popularity within the social sciences; however, it has received less attention in the occupational therapy literature. The current scoping review aims to explore how studies utilizing a QCSM help inform occupational therapy knowledge and practice. Electronic searches were conducted in April 2017, and the resultant 388 publications were screened by three reviewers in Covidence. In all, 27 publications met the inclusion criteria and were included in the scoping review. Case studies in the occupational therapy literature have explored phenomena relating to the delivery of intervention, theoretical concepts, clinical reasoning, and education and research methods and were situated in a range of different practice areas and contexts. QCSM is a valuable approach in occupational therapy research that contributes to the body of knowledge and theory that informs occupational therapy practice.